Two competing perspectives have influenced the debate concerning the approach to be adopted in searchofcontinental-wide integration in Africa. Although both perspectives argue for the idea of a "United States of Africa", the approach of former Libyan leader, Muhammar Gaddafi, advocated for holistic integration, whilst other African leaders, spearheaded by Thabo Mbeki, argued forincrementalism aimed at first strengthening regional integration. Whereas theAfrican Union (AU) has accepted incrementalism as the preferred approach to continental integration, minimal emphasis has been placed on what this approach should constitute. Drawing from the successes of the Southern African Power Pool (SAPP) and West African Power Pool (WAPP), this article argues that functional developmentalism is most suitable to strengthening Regional Economic Communities (RECs) throughout the continent. It postulates that functional developmentalism signifies a more effective role for hegemons which is firmly entrenched in the principles and norms of cooperative hegemony. Using the criteria for cooperative hegemony, namely capacities for power sharing, power aggregation and commitment, it illustrates the potential for enhancing regional cooperation.
The book characterizes colonialism as a duress contract entered into by the colonized and enforced by the colonizers. The contributors argue that the colonial "contract" must be voided because of the dehumanization and oppression implied. Only when unmasked and fully comprehended can colonialism be halted.
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ObjectivesA Sore Throat Test and Treat (STTT) service was introduced in selected community pharmacies to screen against Streptococcus A and appropriately treat infections, relieving pressure on General Practices (GP). The long-term impact on patient and NHS outcomes is unclear. A robust evaluation is required to inform future policy and roll-out.
ApproachA matched cohort study comparing patients who received an STTT consultation in community pharmacy (exposed) compared to consultation with GP (unexposed). Individual-level data from participating STTT pharmacies were extracted from the Choose Pharmacy IT platform, anonymised and acquired into the Secure Anonymised Information Linkage (SAIL) Databank. Both cohorts were linked to other longitudinal health and administrative data within SAIL to create study outcomes (e.g. antibiotic prescribing, re-consultation, attendance/admission at Emergency Department/hospital). The impact of the STTT service was evaluated by modelling the outcomes using logistic regression to calculate odds ratios.
Results7553 patients exposed to the STTT service (8,313 consultations) in community pharmacies in Cwm Taf Morgannwg and Betsi Cadwaladr University Health Boards between 1st November 2018 and 28th February 2020, were successfully anonymised and acquired into the SAIL Databank (97.16%). 99.5% of these individuals were then linked to the Welsh Demographic Service Dataset (WDSD), enabling demographics to be generated. 6,665 distinct consultations remained in the exposed group after exclusion criteria were applied. A matched unexposed cohort will be created, and odds ratios will be presented to compare the risk of each outcome for those exposed to the STTT service compared to usual care.
ConclusionThis innovative study is the first to link national pharmacy service data to individual-level population-scale longitudinal health and administrative data in the SAIL Databank. Our findings will inform clear and actionable recommendations regarding the service design and future roll-out of STTT services across the UK and internationally.
AbstractVitamin D is an important nutrient for bone health, and vitamin D deficiency increases the risk of various diseases. Gilgit Baltistan, the northern-most area of Pakistan, has a high prevalence of vitamin D deficiency, despite many nutritional and food safety programmes. The present study aimed to find how knowledge, attitudes and practices associated with vitamin D related to the prevalence of vitamin D deficiency among people residing in different areas of Gilgit Baltistan. The cross-sectional study was descriptive and used data from a survey carried out between February 2019 and December 2020 on individuals of both sexes aged 10 years or over in Gilgit Baltistan. Of the 575 survey participants, 306 (53.2%) had experienced signs and symptoms of vitamin D deficiency, i.e. tiredness, fatigue and bone weakness. Approximately 64.8% had some general knowledge of vitamin D and its relation to health. Participants aged 19–25 years had the highest scores on knowledge of vitamin D. Only 22.7% of interviewees had ever taken any supplements and only 25.6% often exposed themselves to sunlight. Females' mean knowledge score (28.7; SD 7.02) was higher than that of males (24; SD 9.01). A lack of consistency was observed between attitude towards daylight exposure and knowledge of vitamin D. There was a large correlation between knowledge and attitude (p = 0.001), while a non-significant association was demonstrated between knowledge and practices (p = 0.1). Better knowledge, attitude and practices by people living in cities or more-developed regions indicates that education can be an effective way to provide awareness regarding micronutrient deficiencies. More emphasis is needed on enhancing knowledge, awareness and practices associated with vitamin D deficiency in rural areas of Pakistan. It is strongly recommended that an awareness campaign on micronutrients is launched in both rural and urban areas of Pakistan, concentrating on poor socioeconomic settings.
Echinococcosis is considered a cosmopolitan zoonosis caused by different species of small taeniid tapeworms of the genus Echinococcus and is regarded as a neglected zoonosis. Cystic and alveolar echinococcoses are endemic diseases of Tibetan, Pamir, and Iranian plateaus. All of the countries within the Iranian plateau are affected by echinococcosis. Pakistan, Turkey, and Iran are the three most populous countries of the region, in which echinococcosis is highly endemic. The three neighboring countries share strong cultural and socioeconomic ties. The present study aimed to provide a broad review of the status of cystic and alveolar echinococcosis, summarizing the current knowledge about geographical distribution, molecular epidemiology, and transmission dynamics of Echinococcus granulosus sensu lato and Echinococcus multilocularis in this region. Additionally, we aimed to understand disease burden and risk factors as basic requirements for establishing a surveillance system and planning prevention and control programs. A considerable body of information is available on different aspects of echinococcosis in this region; however, several information and research gaps need to be filled before planning control programs. None of the countries in the region have an elaborate echinococcosis control program. Effective control programs require multi/intersectoral coordination within a One Health approach with a long-term political and administrative commitment and enhanced international collaboration among the three countries.
Background: The parasitic disease, cystic echinococcosis (CE), is a serious health problem in Pakistan. Risk of disease transmission is increased by economic and political instability, poor living conditions, and limited awareness of hygienic practices. The current study aimed to investigate the community perception and awareness regarding the risk factors of CE in Pakistan, from a One Health perspective. Methods: We conducted a community-based survey involving 454 participants in the major cities of Pakistan. Quantitative data based on knowledge, attitude, and practices (KAP), the One Health concept, risk factors, and community perception of CE among the general population of the major cities of Pakistan were collected. The questions included those related to knowledge, attitude, practices, One Health concept, risk factors, and community perception. The Chi-squared test was applied to determine the associations regarding KAPs across socio-demographic parameters. Results: KAPs had no significant associations with sociodemographic aspects such as age, sex, religion, ethnicity, education, marital status, occupation, or financial status of the participants. The findings indicated a lack of awareness about CE among the participants. Respondents were unaware of the risk factors and the One Health concept of CE. However, the community attitude and perception were positive toward the control of CE. Conclusion: Illiteracy, deficient sanitation systems and lack of awareness are the contributing factors to CE in Pakistan. It is necessary to make the community aware regarding CE and its importance. Increasing this awareness represents an important step toward the eradication and control of CE.
The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020.
In: Micah , A E , Cogswell , I E , Cunningham , B , Ezoe , S , Harle , A C , Maddison , E R , McCracken , D , Nomura , S , Simpson , K E , Stutzman , H N , Tsakalos , G , Wallace , L E , Zhao , Y , Zende , R R , Abbafati , C , Abdelmasseh , M , Abedi , A , Abegaz , K H , Abhilash , E S , Abolhassani , H , Abrigo , M R M , Adhikari , T B , Afzal , S , Ahinkorah , B O , Ahmadi , S , Ahmed , H , Ahmed , M B , Rashid , T A , Ajami , M , Aji , B , Akalu , Y , Akunna , C J , Al Hamad , H , Alam , K , Alanezi , F M , Alanzi , T M , Alemayehu , Y , Alhassan , R K , Alinia , C , Aljunid , S M , Almustanyir , S A , Alvis-Guzman , N , Alvis-Zakzuk , N J , Amini , S , Amini-Rarani , M , Amu , H , Ancuceanu , R , Andrei , C L , Andrei , T , Angell , B & Global Burden Dis Hlth Financing 2021 , ' Tracking development assistance for health and for COVID-19 : a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990-2050 ' , Lancet , vol. 398 , no. 10308 , pp. 1317-1343 . https://doi.org/10.1016/S0140-6736(21)01258-7
Background: The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. Methods: We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$ per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. Findings: In 2019, health spending globally reached $8·8 trillion (95% uncertainty interval [UI] 8·7–8·8) or $1132 (1119–1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total, $40·4 billion (0·5%, 95% UI 0·5–0·5) was ...
Background The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020.